Dáil Éireann debate -
Tuesday, 15 Mar 1988

Vol. 379 No. 1

Ceisteanna—Questions. Oral Answers. - Health Services Charges.

16.

Mr. Sherlock

asked the Minister for Health if his attention has been drawn to the plans of some health boards to introduce charges for the issuing of hospital services cards and form E111, which is required to establish a person's entitlement for free medical services in other EC countries; if his agreement has been sought for the introduction of such charges; if such permission has been given in any health boards; if so, the health boards to which it has been given; and if he will make a statement on the matter.

68.

Mr. Howlin

asked the Minister for Health if he proposes to introduce new regulations under section 72 of the Health Act, 1970, dealing with the administration of services and providing for charges for a range of such services, including the processing of forms such as hospital services card applications and applications for Form E111.

188.

Mr. Allen

asked the Minister for Health the steps, if any, he has taken to ensure that the health boards withdraw the £10 administrative charge for the granting of E111 forms.

Mr. Leyden

I think Question No. 16 is being taken with a priority question.

Proinsias De Rossa

It may be taken with a priority question but it must be answered now.

An Ceann Comhairle

Questions Nos. 16, 68 and 188 to be taken together.

Mr. Leyden

Is it in order if I take No. 16 with No. 68 which is a priority question?

An Ceann Comhairle

That is quite in order.

Mr. Howlin

We have approximately one and a half minutes left of ordinary Question Time before we go on to priority questions.

An Ceann Comhairle

The Deputy is not helping me to save time.

Mr. Howlin

I am concerned, because this is the only priority question I am allowed to put on the Order Paper, as to whether we will have time for supplementaries.

An Ceann Comhairle

I will give no assurance to the Deputy along those lines. You must trust the Chair on matters of that kind. The Chair is being quite liberal in that regard, that is, in so far as he can.

Mr. Leyden

I propose to take Questions Nos. 16, 68 and 188 together.

Section 72 does not permit the introduction of regulations which provide for charges in respect of the administrative services referred to by the Deputy. I am examining the implications of the charges in question and I will make a statement on the matter when that examination is completed.

Mr. Sherlock

My question refers to the implementation of the £10 charge in relation to form E111. Has the Minister given permission to any health board to impose this charge or has he been requested by the Southern Health Board for permission to impose such charge? I would like him to say if such charges are being imposed on pilgrimages or school tours abroad. To impose a £10 charge on people who are marginally over the limit for medical card eligibility and who contribute 1½ per cent of their income, which amounts to £200 per annum, is unrealistic. This charge is being imposed when £1.5 million is owed to the health boards by consultants who have used the boards' facilities. Up to 1984 £2 million was owed in health contributions which were uncollected from farmers and the selfemployed. There have been no health contributions collected since 1984.

An Ceann Comhairle

The Deputy seems to be imparting a lot of information rather than seeking it.

Mr. Sherlock

In those circumstances would the Minister agree that it is savage to impose a £10 charge on people who are marginally beyond the elegibility limit for medical cards? It constitutes a savage imposition on such people — the Minister should not be in any doubt about it — and I should like to ascertain whether the Minister gave permission to the Southern Health Board to impose such charges.

An Ceann Comhairle

I must insist on brief supplementaries.

Mr. Leyden

I might reiterate that the provisions of section 72 of the Health Act, 1970, do not permit the introduction of regulations to provide for the levying of charges in respect of the administration of the services referred to by the Deputy.

Proinsias De Rossa

So they are illegal;

Miss Flaherty

So they are illegal.

Mr. Leyden

The Deputy will be well aware that, because we have authority under the provisions of section 72, we could not grant such permission to health boards. I might bring it to the attention of the House that the purpose of the charges is to enable health boards to retain staff to deal with services which would otherwise have to be discontinued or be the subject of lengthy delays.

(Interruptions.)

Mr. Sherlock

Therefore, health boards are illegally imposing these charges?

Mr. Howlin

It is interesting to note from the Minister's reply that it is not possible, under present legislation, to impose such charges, which would lead one to deduce that the charges being levied by the Southern Health Board, to be introduced by the Eastern Health Board and the Midland Health Board are all illegal. I have put questions to the Minister over a period of months asking for clarification in this regard. Each time my questions have been ruled out of order through lack of ministerial responsibility in this area. Since the Minister has been aware that the charges are being imposed and collected — and the fact is he seems to be implying that they are illegal — would he instruct health boards to desist from charging people illegally in this manner?

Mr. Leyden

The Minister is at present examining the implications of the charges in question and will make a statement on the matter when his examination has been completed.

Mr. Howlin

In the meantime will the Minister instruct health boards to act within the law?

An Ceann Comhairle

Deputy Howlin——

Mr. Howlin

This is a very important question.

An Ceann Comhairle

I am anxious to facilitate the Deputy.

Mr. Howlin

I will repeat my question: as the Minister has indicated to the House that charges are being levied which are illegal, that he is aware of them, because I have put questions down to him on this issue over a number of months, particularly in relation to a range of charges from applications for hospital services cards right down to mortuary charges — would he now indicate to the House that such charges will not be collectable and that he will instruct health boards to cease collecting them until such time as they are rendered legal by an Act of this House, or in some other fashion?

An Ceann Comhairle

Regrettably we are having repetition.

Mr. Leyden

I will repeat that the Minister is examining the implications of the charges in question and will make a statement on the matter when his examination has been completed.

Mr. Howlin

In the meantime patients should not pay.

An Ceann Comhairle

We must now proceed to deal formally with questions nominated for priority. The next question will be No. 65 in the name of Deputy Allen.